Insurance Glossary: 60+ Essential Indian Insurance Terms

The percentage of claims paid by an insurer out of the total claims received during a financial year. Published annually in the IRDAI Handbook. High CSR (>98%) indicates reliable claim handling.

The proportion of total claimed rupees actually paid out by the insurer. ASR prevents insurers from inflating CSR by paying numerous small claims while denying large life cover payouts.

The maximum fixed sum assured by the insurer in case of total loss or theft of a vehicle. It equals the manufacturer's listed selling price adjusted for age-based depreciation.

A reward discount ranging from 20% to 50% given on the Own Damage premium for every claim-free policy year. NCB is tied to the policyholder, not the car, and can be transferred to a new vehicle.

An essential rider where the insurer waives the standard 50% depreciation deduction on plastic, nylon, and rubber components, and 30% on fiberglass parts during accident repairs.

Any health condition, symptom, or ailment diagnosed or treated within 36 months (reduced from 48 months by IRDAI in 2024) prior to the inception of the health insurance policy.

After a health policy has completed 60 consecutive continuous months of coverage without lapse, the insurer cannot question or contest any claim on grounds of non-disclosure or misstatement, except in cases of proven deliberate fraud.

A statutory protection clause under Section 6 of the MWP Act ensuring that the death claim proceeds from a term policy belong exclusively to the policyholder's wife and children, legally insulated from business creditors, recovery notices, and court attachments.

The ratio of net claims paid to net premiums collected by an insurer. An ideal ICR sits between 70% and 90%. Below 60% indicates tight claim rejections; above 100% indicates the insurer is operating at a financial loss and may increase future renewal premiums.

An IRDAI-licensed intermediary hired by health insurance companies to administer hospital cashless empanelment, scrutinize reimbursement bills, and coordinate cashless authorization letters.

A metric indicating an insurance company's financial capability to pay all claims even in catastrophic disaster scenarios. IRDAI mandates a minimum Solvency Ratio of 1.50 (150%).

An affordable health policy that triggers once total cumulative medical claims across a full policy year exceed a specified threshold ("Deductible"). It provides massive ₹50L–₹1Cr coverage at a fraction of base policy cost.

A punitive policy clause where choosing a hospital room higher than your policy's room rent sub-limit causes the insurer to proportionally deduct doctor fees, surgery, and nursing expenses by the same ratio.

The official digital grievance redressal portal operated by the Insurance Regulatory and Development Authority of India (IRDAI) to track and escalate unresolved policyholder complaints against insurers.